Effects of exercise on health-related fitness and patient-reported outcomes in survivors of head and neck cancer: a systematic review and meta-analysis.

[BACKGROUND] Despite improvements in treatments, patients with head and neck cancer (HNC) still endure severe acute and chronic side effects.

[PURPOSE] To systematically summarize the effects of exercise on patient-reported and health-related fitness outcomes in patients with HNC.

[METHODS] Electronic searches were conducted in MEDLINE, Scopus, CINAHL, and EMBASE from November 2022 to January 2023. A revised search was conducted in March 2025 and included studies from all time (1946-2025). The PRISMA Statement was used to guide this review.

[RESULTS] We identified 8 studies for quantitative synthesis and meta-analysis. Adherence was great and averaged 83.8% for resistance training only or resistance and aerobic training. No exercise-related adverse events were reported. There were statistically significant and/or clinically meaningful differences favouring the exercise groups for functional capacity assessed by the six-minute walk test (Mean Difference [MD]: 97.9 m [95% Confidence Interval [CI]: 78.2 to 117.6, p < 0.001); lower body flexibility assessed by the sit and reach test (MD: 7.16 [95% CI: 0.11 to 14.21], p = 0.05); balance assessed by the timed up and go test (MD: 0.97 [95% CI: -0.36 to 2.30], p = 0.15); and quality of life (QoL) assessed by validated questionnaires (Standardized MD: 0.51 [95% CI: 0.39 to 0.64], p < 0.001), respectively. Studies were of low quality due to biases, small sample sizes, and heterogeneity in assessment tools, outcome assessed, exercise doses, and follow-up periods.

[CONCLUSION] Preliminary evidence supports the beneficial effects of exercise on physical function, QoL, and flexibility in patients with HNC. There is a need for methodologically stronger research across all phases of the HNC continuum.